Effect of serum miRNAs and low-dose CT in identifying the type of pulmonary nodules
Objective To study the differences in the expression of miR-210,miR-1290 and miR-19a in the serum of pa-tients with pulmonary nodules and the feasibility on combining with low-dose computed tomography(LDCT)to improve the diagnostic efficacy of benign and malignant pulmonary nodules.Methods Totally 77 patients with pulmonary nodules who consulted 960th Hospital of the PLA from September 01,2022 to March 31,2023 for symptomatic specialties were randomly included in the study.All patients underwent LDCT and detected the relative expression levels of serum miR-210,miR-1290 and miR-19a by real-time fluorescence quantitative polymerase chain reaction(qRT-PCR)to identify the type of the pulmonary nodules,while surgery or puncture biopsy as the gold standard.The relationship between benign and malignant pulmonary nodules and imaging signs was analyzed using thex2test.Comparison of the relative expression of each miRNA between groups was performed by using the Mann-Whitney U test.The effect of the three miRNAs in identifying benign and malignant pulmonary nodules was evaluated by plotting ROC curves,and further evaluating the dif-ferential diagnostic effect of miRNAs combined with LDCT scanning results.Results LDCT lung scan detected malig-nant pulmonary nodules in 61 cases and benign pulmonary nodules in 16 cases.The expression of miR-210,miR-1290,and miR-19a in the serum of patients with malignant pulmonary nodules was significantly higher than that of patients with benign pulmonary nodules(all P＜0.05).The AUC values for the diagnosis of benign and malignant pulmonary nodules for miR-210,miR-1290,and miR-19a were 0.699,0.709 and 0.697,respectively,and the AUC for the combined detec-tion of the three miRNAs was 0.768.The combination of the three miRNAs detected malignant pulmonary nodules in 37 cases and benign pulmonary nodules in 40 cases.The diagnosis of malignant pulmonary nodules was confirmed in 47 cases and benign pulmonary nodules in 30 cases by pathologic tissue sections.Among them,41 cases of malignant pulmonary nodules and 10 cases of benign pulmonary nodules detected by LDCT were consistent with the pathological diagnosis,and the accuracy of identifying the type of pulmonary nodules was 66.2％.Imaging showed a significantly higher incidence of nodal density changes,lobular sign,burr sign,vacuolar sign,and pleural pulling in those with malignant lung nodules than in those with benign lung nodules(x2 values were 13.508,10.100,6.337,18.731 and 13.766,respectively,all P＜0.05).The combination of the three miRNAs identified 30 malignant and 23 benign pulmonary nodules,all of which were consistent with the pathological diagnosis.The accuracy of identifying the type of pulmonary nodules was 68.8％.The combination of LDCT and the three miRNAs identified 44 malignant and 26 benign pulmonary nodules,all of which were consistent with the pathological diagnosis.The sensitivity,specificity,and accuracy of determining the type of pul-monary nodules increased to 93.6％,86.7％,and 90.9％,respectively.Conclusion LDCT lung scan combined with ser-um miR-210,miR-1290 and miR-19a detection improves the accuracy of identifying the type of pulmonary nodules and has practical clinical significance in the differential diagnosis of benign and malignant pulmonary nodules.
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